The eyes, the thyroid, and aging
In the eyes of a diabetic
Diabetes damages the eyes in various ways; the most common conditions are glaucoma, cataracts, diabetic retinopathy (DR), and retinal detachment, which can affect vision and even cause blindness.
Its severity is related to high and sustained sugar levels, high cholesterol, duration of diabetes (the longer the duration, the greater the severity), hypertension, smoking, pregnancy, and kidney disease.
Hyperglycemia leads to inflammatory changes in the retina, causing deterioration that can become severe or irreversible. It also affects the lens's ability to focus, impairing distance vision (similar to myopia) with high blood sugar levels. Once blood sugar begins to decrease, the opposite effect occurs, worsening near vision (diabetic presbyopia). This is a temporary and reversible condition. It is important to explain this condition to patients because of the misconception that diabetes treatments damage eyesight, leading them to abandon treatment and thus risk developing vision-threatening complications.
Retinopathy of prematurity (ROP) is initially asymptomatic, with no obvious findings on physical examination. During this period, changes occur in the retina that lead to its deterioration. Symptoms arise in advanced stages when the damage is severe (decreased night vision, floaters, blind spots or areas, and vision loss). In certain conditions, eye pain or double vision may occur due to involvement of the eye muscles.
You shouldn't wait for symptoms to appear before seeing a doctor. Early and regular eye exams are essential for timely diagnosis, determining the severity of the condition, and initiating appropriate treatment.
The best therapy is prevention by achieving good control of blood glucose (HbA1c <7%), cholesterol, blood pressure, weight, proper diet, adherence to the prescribed drug treatment, and exercise that should be specified by the doctor, since in some cases impact or resistance exercises such as boxing, weightlifting, jogging, or activities that increase pressure (blowing up balloons) should be avoided.
Hypothyroidism
The thyroid is a butterfly-shaped gland located in the front of the neck and performs its functions by producing thyroxine (T4) and triiodothyronine (T3), which are in turn regulated by thyroid-stimulating hormone (TSH).
Thyroid disease is more prevalent in women, and 60% of people who suffer from thyroid problems are unaware of it.
Certain thyroid conditions cause a decrease in hormone production (hypothyroidism), this being the most common functional alteration; its causes are diverse such as autoimmune or Hashimoto's thyroiditis (most frequent) and other forms of thyroiditis, iodine deficiency, thyroid surgeries, radioactive iodine therapy (I 131 ), medications, external radiotherapy, infectious or infiltrative diseases.
It is associated with a family history of thyroid disease, Down syndrome, and autoimmune diseases. Elevated LDL cholesterol, anemia, and high prolactin levels are common.
Its symptoms are often nonspecific but suggestive of illness, such as a slow heart rate, dry skin and hair, paleness, loss of eyebrows, decreased sweating, cold intolerance, thick tongue, swelling in the eyes, face, and ankles; hoarse voice, constipation, weakness in lifting arms or legs, climbing stairs, easy fatigue, and slowness in speech, thought, learning, movement, reflexes (Achilles tendon), and metabolism (obesity). Cognitive and memory impairments, menstrual irregularities (heavy and/or prolonged periods), and fertility problems may also occur.
The nonspecific nature of the symptoms makes diagnosis difficult; all suspected cases should be evaluated, as in pregnancy and in the newborn, mainly by measuring TSH and T4L levels; other studies would be proposed by the specialist.
The treatment consists of administering replacement doses of thyroid hormone (levothyroxine).
Active aging
Old age is a stage of life, and aging is an involutive process that occurs throughout it. Both are inherent to our bio-psycho-social reality.
Old age is a stage that begins at age 60 and ends at death; it is a period of biological and functional changes in all areas of the body. Aging, on the other hand, is a universal process, inherent to all living beings, and begins from the moment of conception. It includes three components: biological, social, and psychological aging.
This process is characterized by a decrease in the individual's adaptive capacity to their environment, making them increasingly sensitive, vulnerable, and fragile to their surroundings. In the Darwinian concept of the survival of the fittest, the individual experiences a physical decline that they themselves recognize, with changes in their habits and routines, replacing them with less demanding activities, and a tendency toward isolation, loss of self-esteem, and a loss of autonomy.
Social rejection is generated in the environment when they are not suitable for activities that require better physical conditions with changes in their status quo that lead to processes of self-devaluation, demotivation, social isolation and depression that affects the cognitive domain with a decrease in the ability to concentrate, coordination, memory and reaction to circumstances.
The approach to this period depends on cultural concepts, historical moment, socioeconomic class, the individual's psychological attitudes and family attitude; all of this could lead to a sublimated gerontophobia that accelerates neuropsychological deterioration.
Positive and active aging should include a framework of adequate physical, mental, and social conditions. Reinforcing healthy habits and cognitive stimulation through activities and exercises are effective tools for minimizing the decline in cognitive abilities (memory, attention, language, reasoning, and planning) in older adults. Caregivers, family members, and therapists (whether in person or virtually) should be involved.
If you would like more information, please contact us or add comments.
Dr. Lucia M. Gonçalves Jardim
Internal Medicine Physician.
Specialist in Endocrinology and Metabolism
Email: luciamgoncalvesj@gmail.com
Telephone: +351 939 056 458